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Syrian forces have conducted four days of airstrikes in Eastern Ghouta, group says

Strikes escalated after a Russian warplane was shot down over the weekend

(CNN)More than 200 civilians have been killed since Monday in Syrian government airstrikes on parts of rebel-held Eastern Ghouta near Damascus, the Syrian Observatory for Human Rights said Thursday. Among the deaths were 54 children and 41 women.

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Russian airstrikes hit rebel-controlled Idlib

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Russian airstrikes hit rebel-controlled Idlib01:10

Airstrikes escalated in recent days after a Russian warplane was shot down over the weekend in the rebel-held northwestern province of Idlib.

Relying on information from activists on the ground, the Syrian Observatory for Human Rights said it counted 213 civilian deaths over four days: 31 on Monday, 81 on Tuesday, 41 on Wednesday and 60 on Thursday.

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Syrian activists report rapidly deteriorating conditions -- the worst in four years -- in the area controlled by various Islamic rebel groups, with hundreds of thousands of residents struggling from shortages of food and medical supplies.

The Eastern Ghouta area was supposed to be a "de-escalation zone," according to a peace agreement struck by Russia, Turkey and Iran in May.

About 400,000 Syrians have been killed since the conflict erupted in 2011, according to the United Nations.